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Chapter 2 Theories and Treatments of Abnormality

Biological Approaches

Abnormality due to brain dysfunction, biochemical imbalance,


genetic abnormalities
Treatment antipsychotics, antidepressants, antianxiety drugs,
ECT therapy

Behavioral Approaches

Focus on the influences of reinforcements and punishments in


producing behavior
Classical conditioning (Pavlov) form of learning in which a
neutral stimulus becomes associated with a stimulus that
naturally elicits a response, thereby making the neutral stimulus
itself sufficient to elicit the same response
o Unconditioned stimulus naturally produces the response
o Unconditioned response response created by the
unconditioned stimulus
o Conditioned stimulus previously neutral but, through
pairing with a natural stimulus, elicits a response
o Conditioned response response that first follows a
unconditioned stimulus but now follows a conditioned
stimulus
Operant conditioning (Skinner) shaping of behaviors by
providing rewards for desired behaviors and providing
punishments for undesired behaviors
o Continuous vs. partial reinforcement schedule behaviors
learned more quickly on a continuous schedule and are
harder to eliminate on a partial schedule
o Conditioned avoidance response avoiding stimulus
reduces anxiety, reinforces avoidance
o Positive reinforcement adding a stimulus
o Negative reinforcement removing or avoiding aversive
stimulus
Modeling learning new behaviors by imitating behaviors
modeled by important figures in ones life, such as parents (more
likely to model if figure is an authority figure or perceived to be
similar to the individual)
Observational learning when a person observes the rewards
and punishments that another person receives for his or her
behavior and then behaves in accord with those rewards and
punishments

Behavioral Therapies
Focuses on identifying the reinforcements and punishments
contributing to a persons maladaptive behaviors and on
changing specific behaviors
Initial behavioral assessment of problem
Systematic desensitization gradual method for extinguishing
anxiety responses to stimuli and the maladaptive behavior that
often accompanies this anxiety
o The client first learns relaxation exercises and then
develops a hierarchy of feared stimuli, ranging from stimuli
that would cause him or her only mild anxiety to stimuli
that would cause severe anxiety or panic
o Therapist would help client proceed through hierarchy,
starting with the least feared stimulus and proceeding until
the client reaches the most-feared stimulus on the list and
is able to experience this stimulus without anxiety
o Paired with modeling witnessing the therapist do feared
things and imitating their behavior
Cognitive Approaches

Idea that our cognitions (thoughts or beliefs) shape our behaviors


and the emotions we experience
Casual attribution our answer to why an event happened, can
influence our behavior because they impact the meaning we give
to events and our expectations for similar events in the future
Global assumptions - broad beliefs about ourselves, our
relationships, and the world; can be either positive and helpful to
us or negative and destructive

Cognitive Therapies
Short-term, meant to help clients identify and challenge negative
thoughts and dysfunctional belief systems.
Cognitive therapists also help clients learn more effective
problem-solving techniques for dealing with the concrete
problems in their lives
3 main goals:
o Assist clients in identifying their irrational and maladaptive
thoughts
o Teach clients to challenge their irrational or maladaptive
thoughts and to consider alternative ways of thinking
o Encourage clients to face their worst fears about a
situation and recognize ways they could cope

Psychodynamic Approaches

Freud, suggests that all behavior, thoughts, and emotions,


whether normal or abnormal, is influenced to a large extent by
unconscious processes
Psychoanalysis method of investigating the mind, form of
psychotherapy treatment
Repression the motivated forgetting of a difficult experience or
of an unacceptable wish (pushing the material into the
unconscious)
Id, ego, superego regulates libido, interactions between the three
occur in the unconscious
Defense mechanisms strategies that the ego uses to disguise
or transform unconscious wishes
o Abnormal behavior occurs when a persons behavior
becomes ruled by defense mechanisms or when the
mechanisms themselves are maladaptive
o Regression, denial, displacement, rationalization,
intellectualization, projection, reaction formation,
identification, sublimation
Psychoanalytic theory argues that the nurturance a child
receives from his or her early caregivers strongly influences
personality development
Psychosexual stages stages in the developmental process
children pass through; in each stage, sex drives are focused on
the stimulation of certain areas of the body, and particular
psychological issues can arouse anxiety
o Can become fixated at a certain stage
o Stages: oral, anal, phallic, latency, genital

Psychodynamic Therapies
Focuses on uncovering and resolving unconscious processes that
are thought to drive psychological symptoms
Goal is to help clients recognize their maladaptive coping
strategies and the sources of their unconscious conflicts
Free association is a method Freud and others use where client
talks about what comes to mind and tries not to censor thoughts
Resistance to certain material is an important clue to the clients
central unconscious conflicts
Therapist provides interpretation of conflict that the client might
be facing, resistance to interpretation might be an indication that
the interpretation has identified an important issue in the clients
unconscious

Transference occurs when the client reacts to the therapist as if


the therapist were an important person in his or her early
development; the clients feelings and beliefs about this other
person are transferred onto the therapist
Working through, or going over and over, painful memories and
difficult issues help clients move forward with their lives
Psychoanalysis involves 3-4 sessions per week over a period of
years
o Focus on the interpretation of transferences and
resistances, as well as on experiences in the clients past
Psychodynamic therapy can last as short as 12 weeks
o Focus more on current situations in the clients life

Biopsychosocial approach
Combination of biological, psychological, and sociocultural
factors to result in the development of a specific disorder
Diathesis vulnerability for a particular disorder
Diathesis stress model disorder will only emerge when a
diathesis or vulnerability interacts with a stress or trigger
Chapter 3 Assessing and Diagnosing Abnormality

Assessment the process of gathering information about


peoples symptoms and the possible causes of these symptoms
Diagnosis a label for a set of symptoms that often occur
together
Syndrome set of symptoms

Assessment Tools
Validity - the accuracy of a test in assessing what it is supposed
to measure
o Face validity the items seem to measure what the test is
intended to measure (at face value)
o Content validity the extent to which a test assesses all
the important aspects of a phenomenon that it purports to
measure
o Concurrent validity the extent to which a test yields the
same results as other, established measures of the same
behavior, thoughts, or feelings
o Predictive validity predicting how a person will think, act,
or feel in the future

o Construct validity the extent to which a test measures


what it is supposed to measure and not something else
altogether
Reliability indicates a tests consistency in measuring what it is
supposed to measure
o Test-retest reliability describes how consistent the results
of a test are over time
o Alternate form reliability - when peoples answers to
different forms of a test are similar
o Internal reliability similarity in peoples answers among
different parts of the same test
o Interrator reliability different raters or judges who
administer and score the interview or test should come to
similar conclusions when they are evaluating the same
people

Assessment Types
Symptom questionnaire a questionnaire that assesses what
symptoms a person is experiencing
Personality inventories questionnaires meant to assess peoples
typical ways of thinking, feeling, and behaving; are used as part
of an assessment procedure to obtain information on peoples
well-being, self-concept, attitudes and beliefs, ways of coping,
perceptions of their environment and social resources, and
vulnerabilities
o MMPI most common personality test
Intelligence tests used to get a sense of an individuals
intellectual strengths and weaknesses, particularly when mental
retardation or brain damage is suspected
Neuropsychological tests may be useful in detecting specific
cognitive deficits such as a memory problem
Projective tests based on the assumption that when people are
presented with an ambiguous stimulus, they will interpret the
stimulus in line with their current concerns and feelings, their
relationships with others, and conflicts or desires
o Rorschach Inkblot test, TAT test
Clinical Interviewing
For mental status exam, note:
o Appearance and behavior
o Thought processes
o Mood and affect
o Intellectual functioning
o Orientation to time and space

Challenges include resistance to providing information, cultural


biases
Hills 3 stage model of helping relationships
o Exploration helping clients explore their thoughts,
feelings, and actions
o Insight helping clients understand their thoughts,
feelings, and actions
o Action helping clients decide what actions to take on the
basis of their exploration and insight
Helper behaviors during exploration stage:
o Attending and listening (eye contact, facial expression,
paralanguage, proxemics, kinesics)
o Open ended questions
o Restatement
o Reflection of feeling
Initial interview identify and explore clients chief complaint,
assess clients mental status, assess clients personal history and
interpersonal style and skills, evaluate clients current situation
Mental state assessment affect and mood, speech and thought,
perceptual disturbances, orientation and consciousness, memory
and intelligence

DSM
Prevalence proportion of the population who have a specific
disorder at a given point or period in time
Incidence number of new cases of a specific disorder that
develop during a specific period of time
Comorbidity overlap among disorders

Chapter 4 The Research Endeavor

Operationalization the way we measure or manipulate the


variables in a study
Ethical Issues understanding the study, confidentiality, right to
refuse or withdraw participation, informed consent, deception,
debriefing
Case studies lack of generalizability and objectivity
Correlational studies examine relationship between IV and DV
without manipulating either

o Cross sectional (observing people at only one point in time)


or longitudinal (observing people on two or more occasions
over time)
Meta-analysis a statistical technique for summarizing results
across several studies

Experimental Studies
External validity the extent to which a studys results can be
generalized to real-life phenomena
Internal validity changes in the dependent variable can
confidently be attributed to our manipulation of the independent
variable and not to other factors
o Control other variables by using control group,
experimental group, random assignment higher internal
validity
o Threats to internal validity: selection differences, attrition
(drop-out), experimenter bias, history (events that arent a
part of the study affect outcome), maturation, regression
to mean (on follow up assessments)
Chapter 7 Mood Disorders and Suicide
Unipolar depression depression without mania
o Major depression diagnosis of major depression requires
that a person experience either depressed mood or loss of
interest in usual activities, plus at least four other
symptoms of depression, chronically for at least 2 weeks,
symptoms must be severe enough to interfere with the
persons ability to function in everyday life
o Dysthymic - less severe than major depression but more
chronic, person must experience depressed mood plus two
symptoms for at least 2 years
Bipolar disorder
o Bipolar I manic episodes
o Bipolar II severe episodes of depression with milder
episodes of mania known as hypomania (no hallucinations
or delusions, does not interfere with functioning)
o Cyclothymic disorder alternates between episodes of
hypomania and moderate depression chronically over at
least a 2-year period
Causal attribution is an explanation of why an event happened
Learned helplessness theory suggests that the type of stressful
event most likely to lead to depression is an uncontrollable
negative event

Beck, errors in thinking, cognitive triad